Dideoxyinosine (ddI) shows promise as a treatment for childrenwith AIDS, according to a report published in today's edition ofThe New England Journal of Medicine.

Researchers, led by Karina M. Butler of the National CancerInstitute, found a more sustained response to ddI than to AZT(zidovudine). AZT, sold by Burroughs Wellcome, is the onlyAIDS drug approved by the Food and Drug Administration. DdIwas discovered by researchers at the U.S. National CancerInstitute in 1984 and is being developed by Bristol-MyersSquibb Co. of New York.

CD4 counts in patients receiving AZT usually peak after two tothree months of therapy and return to baseline levels four tosix months after initiation of treatment. Patients in this studymaintained high CD4 levels over at least 24 weeks.

CD4 is a marker that measures the presence of white bloodcells called T helper cells, which are necessary for a healthyimmune system. The AIDS virus tends to kill T helper cells.

Patients with an initial CD4 count of 100 per cubic millimeterresponded to treatment with ddI far better than patients witha CD4 count of less than 100. The best predictor of an increasein the CD4 count in response to ddI was the initial CD4 count atthe time the trial began.

The Phase I/II study of 43 children with HIV (humanimmunodeficiency virus) included 16 who had previously beentreated with AZT. Previous treatment with AZT had no effect onthe response to ddI.

AZT, ddI and a third drug, ddC (dideoxycytidine), belong to aclass of compounds called nucleoside analogs that inhibit thereplication of viral genetic material and slow the progression ofinfection.

The main side effects of ddI are pancreatitis, an inflammationof the pancreas, and peripheral neuropathy, a severe tingling inthe fingers and feet. Two children in the study developedpancreatitis, which was resolved when ddI was discontinued.No children developed neuropathy.

-- Karen Bernstein BioWorld Staff

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